Efficacy and safety of imatinib mesylate (Gleevec) and immunohistochemical expression of c-Kit and PDGFR-beta in a Gynecologic Oncology Group Phase Il Trial in women with recurrent or persistent carcinosarcomas of the uterus.

Academic Article

Abstract

  • PURPOSE: This multi-institutional phase II trial assessed the activity and toxicity of imatinib mesylate and explored c-Kit and platelet-derived growth factor receptor (PDGFR)-beta in recurrent or persistent uterine carcinosarcoma. METHODS: Women with measurable uterine carcinosarcoma, who had a performance status of 0, 1, or 2 and had received up to two prior treatment regimens, were eligible and treated with a 600-mg daily oral dose of imatinib mesylate until disease progression or unacceptable toxicity. Endpoints included progression-free survival (PFS) >or=6 months, overall toxicity, PFS, overall survival (OS), and response. c-Kit and PDGFR-beta were evaluated by immunohistochemistry in archival tumor. RESULTS: Twenty-six women were enrolled, 23 were eligible/evaluable, 1 was ineligible (wrong primary), and 2 were inevaluable (never treated). One subject had a PFS time >or=6 months, yielding the only patient with stable disease. All other patients had progressive disease (n=17) or were inevaluable for tumor response (n=5). Adverse events included grade 4 hypocalcemia (n=1) and grade 3 fatigue, dehydration and anorexia, genitourinary/renal, lymphatic, metabolic, and ocular toxicity (n=1 each, 4%). Positive expression of c-Kit or PDGFR-beta was observed in 88% (14/16) or 40% (6/15) and in 56% (9/16) or 73% (11/15) of cases in the sarcoma and carcinoma component of the tumor, respectively. Expression of c-Kit in the carcinoma component appeared to be associated with worse OS. No other associations were notable. CONCLUSION: Imatinib mesylate was generally well tolerated but had minimal activity as a single agent in unscreened patients. The potential association between carcinomatous c-Kit and OS requires validation.
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    Keywords

  • Adult, Aged, Aged, 80 and over, Antineoplastic Agents, Benzamides, Carcinosarcoma, Disease-Free Survival, Female, Humans, Imatinib Mesylate, Immunohistochemistry, Middle Aged, Neoplasm Recurrence, Local, Piperazines, Proto-Oncogene Proteins c-akt, Proto-Oncogene Proteins c-kit, Pyrimidines, Receptor, Platelet-Derived Growth Factor beta, Treatment Outcome, Uterine Neoplasms
  • Digital Object Identifier (doi)

    Author List

  • Huh WK; Sill MW; Darcy KM; Elias KM; Hoffman JS; Boggess JF; Alvarez RD; Long HJ; O'Malley DM; Birrer MJ
  • Start Page

  • 248
  • End Page

  • 254
  • Volume

  • 117
  • Issue

  • 2